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Authors: Marion Nestle

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CONCLUSION. THE FUTURE OF FOOD SAFETY:
PUBLIC HEALTH VERSUS BIOTERRORISM

1
. GAO.
Bioterrorism: Federal Research and Preparedness Activities
(GAO-01-915), September 2001.
Bioterrorism: Review of Public Health Preparedness Programs
(GAO-02-149T), October 10, 2001.
Food Safety and Security: Fundamental Changes Needed to Ensure Safe Food
(GAO-02-47T), October 10, 2001.

2
. Green E. Britain details the start of its “mad cow” outbreak.
NYT
, January 26, 1999:F2. Brown P, Will RG, Bradley R, et al. Bovine spongiform encephalopathy and variant Creutzfeldt-Jakob disease: background, evolution, and current concerns.
Emerging Infectious Diseases
2001;7:6–16. Balter M. Uncertainties plague projections of vCJD toll.
Science
2001;294:770–771. Projections are imprecise because people ate meat from affected cows from 1980 to 1996, and the disease develops slowly.

3
. Brown P. On the origins of BSE.
Lancet
1998;352:252–253.

4
. Other examples are kuru, a human disease specifically associated with ritualistic cannibalism among the Fore people of Papua New Guinea, and prion diseases specific to mink, deer, cats, and a great variety of exotic animals. Two Nobel Prizes honor this work: to Carleton Gajdusek for studies of kuru and
Creutzfeldt-Jakob disease (1976), and to Stanley Prusiner for discovering and naming prions (1997).

5
. Prusiner SB. Prion diseases and the BSE crisis.
Science
1997;278:245–251. But see: Chesebro B. BSE and prions: uncertainties about the agent.
Science
1998;279:42–43. Prions are believed to cause proteins in the brain and nervous system to fold improperly. Like other proteins, prions should be inactivated by acid in the stomach, and digested (disassembled) to amino acids by intestinal enzymes. They are not. Instead, they survive stomach acid and digestive enzymes, pass through the intestinal wall, get carried intact through the blood stream, and penetrate the “blood-brain barrier” that protects the brain from harmful substances. Prion proteins appear to be so tightly folded that they resist inactivation by acid, enzymes, and cooking temperatures. Their improbable behavior is the basis of skepticism and alternative hypotheses (such as a slow-acting virus), but most evidence now favors the existence of prions.

6
. Urry M. Major called for fewer rules on meat hygiene.
Financial Times
(London), June 27–June 28, 1998:7.

7
. Collee JG, Bradley R. BSE: a decade on—part 1.
Lancet
1997;349:636–641 (
part 2
is
Lancet
1997;349:715–721). Nathanson N, Wilesmith J, Griot C. Bovine spongiform encephalopathy (BSE): causes and consequences of a common source epidemic.
Am J Epidemiology
1997;14;959–969.

8
. Will RG, Ironside JW, Zeidler M, et al. A new variant of Creutzfeldt-Jakob disease in the UK.
Lancet
1996;347:921–945. Anderson RM, Donnelly CA, Ferguson NM, et al. Transmission dynamics and epidemiology of BSE in British cattle.
Nature
1996;382:779–788. Scott MR, Will R, Ironside J, et al. Compelling transgenetic evidence for transmission of bovine spongiform encephalopathy prions to humans.
Proceedings of the National Academy of Sciences
1999;96:15137–15142.

9
. Less beef, more brain (editorial).
Lancet
1996;347:915. Darnton J. Britain ties deadly brain disease to cow ailment.
NYT
, March 21, 1996:A1,A7. Lanska DJ. The mad cow problem in the UK: risk perceptions, risk management, and health policy development.
J Public Health Policy
1998;19:160–183.

10
. France will continue beef ban; British pledge to fight in court.
NYT
, December 9, 1999:A6.

11
. FDA. Substances prohibited from use in animal food or feed; animal proteins prohibited in ruminant feed.
FR
62:30935–30978, June 5, 1997. The rules exempted blood, gelatin, cooked meats, and milk, but FDA eliminated the exemption for gelatin later that year (
FR
62:52345–52346, Oct 7, 1997). Stecklow S. Porous borders: despite assurances, U.S. could be at risk for mad-cow disease.
WSJ
, November 28, 2001:A1,A6.

12
. Harvard Center for Risk Analysis.
Evaluation of the Potential for Bovine Spongiform Encephalopathy in the United States: Executive Summary
. USDA/APHIS, November 26, 2001, at
www.aphis.usda.gov/newsroom/
hot_issues/bse/background/documents/mainreporttext.pdf
.

13
. Becker E. U.S. mad cow risk is low, a study by Harvard finds.
NYT
, December 1, 2001:A12.

14
. GAO.
Mad Cow Disease: Improvements in the Animal Feed Ban and
Other Regulatory Areas Would Strengthen U.S. Prevention Efforts
(GAO-02-183), January 2002:3.

15
. Stokes T. Cattlemen continue to beef up efforts to ensure that the U.S. meat supply is safe for consumers.
Nation’s Restaurant News
, May 20, 2002: 40,44.

16
. USDA/FSIS. Current Thinking on Measures That Could Be Implemented to Minimize Human Exposure to Materials That Could Potentially Contain the Bovine Spongiform Encephalopathy (news release), January 15, 2002, at
www.fsis.usda.gov/oa/topics/BSE_thinking.htm
. Kilman S, Carroll J. New precautions discussed to bar mad-cow disease.
WSJ
, January 18, 2002:NB2.

17
. Ono Y. U.S. beef group raises stakes in Japan.
WSJ
, April 22, 2002:A15. CDC. CDC and Florida Department of Health Investigate a Likely Case of New Variant Creutzfeldt Jakob Disease in a U.K. Citizen Residing in the U.S. (press release), April 18, 2002.

18
. Ferguson NM, Donnelly CA, Anderson RM. The foot-and-mouth epidemic in Great Britain: pattern of spread and impact of interventions.
Science
2001;292:1155–1160. Keeling MJ, Woolhouse MEJ, Shaw DJ, et al. Dynamics of the 2001 UK foot and mouth epidemic: stochastic dispersal in a heterogeneous landscape.
Science
2001;294:813–817. Lyall S. A tenacious disease finds new victims in British herds.
NYT
, August 5, 2001:A3.

19
. Enserink M. Barricading U.S. borders against a devastating disease.
Science
2001;291:2298–2300.

20
. Cowell A. Cattle disaster still felt in Britain.
NYT
, September 10, 2002: W1,W7.

21
. Andrews EL. Dutch farmers facing mass foot-and-mouth slaughter.
NYT
, April 6, 2001:A4.

22
. Becker E. Prohibited meat entered U.S., a report finds.
NYT
, August 14, 2001:A12. Stone R. Report urges U.K. to vaccinate herds.
Science
2002;297:319–321.

23
. Robert Koch postulated that (1) anthrax bacteria always are present in the blood of animals sick with the disease but not in healthy animals, (2) inoculation of blood from an animal with anthrax into another animal also causes anthrax, (3) inoculation of anthrax bacteria isolated from the blood of a sick animal and grown in culture will transmit anthrax to the new animal, and (4) anthrax bacteria can be isolated from the new animal. “These conclusions are so certain, that no one will dispute them, and the anthrax bacillus will be looked upon by the scientific world as the causal agent of ordinary, typical anthrax infection in both our domestic animals and in man himself.” See: Koch R. The etiology of tuberculosis (Koch’s postulates), 1884. In: Brock TD.
Milestones in Microbiology: 1556 to 1940
. Washington, DC: American Society of Microbiology, 1998:116–118.

24
. Riemann H, Bryan FL.
Food-Borne Infections and Intoxications
, 2nd ed. New York: Academic Press, 1979:235–238.

25
. CDC. Human ingestion of Bacillus anthracis-contaminated meat—Minnesota, August 2000.
MMWR
2000;49:813–816.

26
. CDC. Human anthrax associated with an epizootic among livestock—North Dakota, 2000.
MMWR
2001;50:677–680.

27
. Guillemin J.
Anthrax: The Investigation of a Deadly Outbreak
. Berkeley: University of California Press, 1999. Meselson M, Guillemin J, Hugh-Jones M, et al. The Sverdlovsk anthrax outbreak of 1979.
Science
1994;266:1202–1208. Inglesby TV, O’Toole T, Henderson DA, et al. Anthrax as a biological weapon, 2002: updated recommendations for management.
JAMA
2002;287:2236–2252.

28
. Ala’Aldeen D. Risk of deliberately induced anthrax outbreak.
Lancet
2001;358:1386–1388.

29
. Kristof ND. Profile of a killer.
NYT
, January 4, 2002:A21. Rosenberg BH. Analysis of the anthrax attacks. Federation of American Scientists, February 5, 2002, at
www.anthraxinvestigation.com/anthraxreport.htm
. Scientist’s suicide linked to anthrax inquiry.
NYT
, August 2, 2008. Also see
NYT
, February 20, 2010.

30
. Broad WJ, Grady D. Science slow to ponder ills that linger in anthrax victims.
NYT
, September 16, 2002:A1,A13. Greenberg DS. US anthrax scares prompt action on bioterrorism.
Lancet
2001;358:1435. Lipton E, Johnson K. Tracking bioterror’s tangled course.
NYT
, December 26, 2001:A1,B4,B5. Stolberg SG, Miller J. Many worry that nation is still highly vulnerable to germ attack.
NYT
, September 9, 2002:A16.

31
. CDC. Investigation of bioterrorism-related anthrax and adverse events from antimicrobial prophylaxis.
MMWR
2001;50:973–976.

32
. Lerner S. Risky chickens.
Village Voice
, December 4, 2001:45. Goldburg R, Florini K. Bayer’s Sale of Modified Cipro May Threaten Public Health (press release). New York: Environmental Defense, October 23, 2001. Silbergeld EK, Walker P. What if Cipro stopped working?
NYT
, November 3, 2001:A23. FDA. NOOH [Notice of Opportunity for Hearing] for poultry fluoroquinolones (background information), December 7, 2000.

33
. Burros M. Poultry industry quietly cuts back on antibiotic use.
NYT
, February 10, 2002:A1,A26.

34
. Chiu C-H, Wu T-L, Su L-H, et al. The emergence in Taiwan of fluoroquinolone resistance in
Salmonella enterica
serotype choleraesuis.
NEJM
2002;346:413–419. McDermott PF, Bodeis SM, English LL, et al. Ciprofloxacin resistance in
Campylobacter jejuni
evolves rapidly in chickens treated with fluoroquinolones.
J Infectious Diseases
2002;185:837–840.

35
. Bayer Signs Financing Agreement for Aventis CropScience Acquisition (press release). Bayer, December 12, 2001.

36
. Andrews MS, Prell MA, eds.
Second Food Security Measurement and Research Conference, Volume II: Papers
. USDA/ERS, July 2001.

37
. United Nations. Universal Declaration of Human Rights (Adopted by the U.N. General Assembly, December 10, 1948). Reprinted in
JAMA
1998;280:469–470.

38
. Oshaug A, Eide WB, Eide A. Human rights: a normative basis for food and nutrition-relevant policies.
Food Policy 1994;19:491–516
. Drèze J, Sen A.
Hunger and Public Action
. Oxford: Clarendon Press, 1989.

39
.
The World Factbook

United States
, 2001. Central Intelligence Agency, at
www.cia.gov/library/publications/the-world-factbook
.

40
. Assefa F, Jabarkhil MZ, Salama P, et al. Malnutrition and mortality in Kohistan district, Afghanistan, April 2001.
JAMA
2001;286:2723–2728. Ahmad
K. Scurvy outbreak in Afghanistan prompts food aid concerns.
Lancet
2002;359: 1044.

41
. Perlez J. Individual meals from the sky.
NYT
, October 8, 2001:B3.

42
. Monbiot G. Folly of aid and bombs.
Guardian
(London), October 9, 2001, at
www.guardian.co.uk/politics/2001/oct/09/afghanistan.britainand911
.

43
. Hungry for peace: with winter near, starving Afghans need more than airdropped relief.
San Francisco Chronicle
, October 26, 2001:A1,A18. Shanker T, Schmitt E. U.S. warns Afghans that Taliban may poison relief food.
NYT
, October 25, 2001:B2

44
. Dao J. Sergeant designs a better box for dropping food to Afghans.
NYT
, October 10, 2001:B3. Waldman A. Food drops go awry, damaging several homes.
NYT
, November 21, 2001:B2. Becker E. Even with roads still open, security fears are choking the flow of food aid.
NYT
, November 30, 2001:B4. Chivers CJ, Becker E. Aid groups say warlords steal as needy wait.
NYT
, January 4, 2002:A1,A15.

45
. Nestle M, Dalton S. Food aid and international hunger crises: the United States in Somalia.
Agriculture and Human Values
1994;11(4):19–27. Lewis P. Downside of doing good: disaster relief can harm.
NYT
, February 27, 1999:B9. McKinlay D. Refugees left in the cold at “slaughterhouse” camp.
Guardian
(London), January 3, 2002. Gall C. Pleas for food, help and a way out.
NYT
, January 20, 2002:A15.

46
. Truelsen S. Food aid and the war on terrorism.
The Voice of Agriculture
. American Farm Bureau Federation, November 5, 2001. See
www.fb.com
.

47
. Burros M. A vulnerable food supply, a call for more safety.
NYT
, October 31, 2001: F1,F8. Mitchell A. Bush gives secrecy power to public health secretary.
NYT
, December 12 2001:B6. Mitchell A. Disputes erupt on Ridge’s needs for his job.
NYT
, November 4, 2001:B7.

48
. Fee E, Brown TM. Preemptive biopreparedness: Can we learn anything from history?
Am J Public Health
2001;91:721–726 (and letter, 1918–1919). The 2nd National Symposium on Medical and Public Health Response to Bio-Terrorism: Public Health Emergency & National Security Threat.
Public Health Reports
2001;116 (suppl 2):1–118. Sobel J, Khan AS, Swerdlow DL. Threat of a biological terrorist attack on the US food supply: the CDC perspective.
Lancet
2002;359:874–880.

BOOK: Safe Food: The Politics of Food Safety
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